BIRADS III , No debe de haber DUDA

Compañers Hablahispana Traducción pendiente de este caso EJEMPLAR , saludos 

Hi again :

Just Now I received an interesting clinical case , which I would Like to SHARE:

1. FEMALE
2. 45 years of age.
3. First Birth at 17
4. Positive Breast Feeding
5. 8 Years with Oral Contraception
6. Last Mammography 18 months.(REPORTED AS NORMAL BIRADS II ) 
7. I week of Left Mastalgia and other minimal symptoms .
8. Non identified Palpable Lesion on either Breast 
9. Axilla : Undetermined 1 cm palpable Lymph Node on the left side. 

REMEMBER : "No radiological exams at all with the following Infrared Images" : 

 I will talk you through them: 

Basal Anterior View : 
Obvious Left Assimetry 
Enhanced Left Vascular Network
Irregular Left Mammary Fold
Single Upper Quadrant (12hrs) Line B on the Left Side.
Slightly Retracted Left Nipple....

Non of the previous findings on the Right...

Oblique View of the Left Breast , notice how entangled is the vascular network....

Physiological or Post  Cold Stress Challenge View:
Normal Right Breast cools down
Abnormal metabolic and Vascular Left Changes are enlightened.
Single Hiperthermia on the Left.

INFRARED ANALYSIS HARBORS :

1. POSITIVE and NEGATIVE PREDICTIVE VALUES FOR DETECTED LESION
2. METABOLIC BEHAVIOUR OF DETECTED LESIONS
3. CAN STABLISH A RISK FOR FUTURE CANCER SPECIALLY IN FAMILIAL CASES AS THIS PATIENT.
4. CAN MONITOR EACH BREAST AS AN INTERVAL PROCEDURE.

"For me there is no doubt at all , Digital Infrared Analysis of the Breast holds an evident truth to be rediscovered by Breast specialists , hopefuly radiologists and Oncologists." EMC.

Keep posted : ANATOMICAL OR MORPHOLOGICAL IMAGES will arrive soon.

My prediction : Positive Case for Breast Carcinoma , Invasive i would say.

"Prediction is often  confused with witchery , specially when the language is UNKNOWN......"

Lets see what happens...................

June 3rd 2013 .
Patient arrived with the following Mammographical and Ultrasound Images:

 Just to point out credibility , done last week and  45 years of age .........

Standard Oblique views , there is a density assimetry in the left breast with a single possibly benign calcification , no architectural distorsion or spiculated lesion.  Inflammatory axillary lymph Nodes. 

Close Up............. density becomes more evident right?

Calls my attention a single Level 1 Lymph node , which has higher   density in  it´s hilium......makes me wonder now....

 Cefalo Caudal Views , subtle central and inner density assimetry in the left breast with the same calcification , a little loss of the retromammary space 

Complementary Ultrasound , plus doppler : 

 I WILL QUOTE : " Left breast with a higher echogenicity , diffuse , with some microcysts and ductal dilations , 

 Elastography showed : left associated  mixed regions  some with a higher or more "solid" nature....

Now here comes UNCERTAINTY : BIRADS III

Standards of care demand a 6 month follow up

Lets BEND the rules , since Clinical knowledge comes from the sum of all previous cases...

I recommended no matter what happens after antiinflammatory treatment and antibiotic  to perfom CBC , Coagulation , and glucose tests. 

And after reviewing the results , i will schedule a Biopsy with a trucut.....

OBVIOUS 2 POSSIBILITIES:

MASTITIS vs Breast Carcinoma possibly T4d : inflammatory.

What do you THINK ? .............well:

"Infrared images are intended ONLY for Breasts Specialists , Breast Cancer Treatment is responsability ONLY for Oncologists.

Detection , Diagnosis and Treatment action depends entirely from : Evidence , History , Experience and a "different sense of feeling" only reserved for those Real Clinitians..........EMC"

(the ones that do not rely only in what they were told , those who  challenge with patience and good intention.... )